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Human papillomavirus and associated Cancer Epidemiology 


Human papillomavirus (HPV) infection causes six (cervical, oropharyngeal, anal, vaginal, vulvar, and penile) cancers. In the era of collective decline in cancer incidence and mortality, we are seeing an increase in oropharyngeal, anal, vaginal, vulvar, and penile cancer incidence in the United States, whereas cervical cancer incidence for the first time in several decades has stabilized. CADS lab researchers study the epidemiology and natural history of HPV, its carcinogenesis, and risk of developing these cancers among the general population and various vulnerable risk groups. 

Notable publications in this area

Oropharyngeal cancer incidence and mortality trends in all 50 states 

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Using data from US Cancer Registries, National Center for Health Statistics, and Surveillance Epidemiology and End Results program, we showed that:

  • Oropharyngeal cancer incidence among men increased nationally at 2.7% per year, with marked increases for cases diagnosed with regional stage and for large (larger than 4 cm) tumors. Rapid increases were concentrated in states from the Midwest and Southeast regions 

  • Women living in Midwest and Southeast are also increasingly suffering from oropharyngeal cancer with an over 2% annual increase 

  • Unfortunately, oropharyngeal cancer mortality also increased 2.1% per year among men

Recent trends in HPV-associated cancers among women

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In this study, we described several new patterns in the human papillomavirus-associated cancer incidence trends among women, notably:

  • For the first time in several decades,  overall cervical cancer incidence has stabilized in recent years 

  • Annual non-cervical cancer burden (measured as the number of cases) surpassed cervical cancer burden in recent years 

  • The most rapid rise was observed for anal cancer among non-Hispanic White women aged 50 years or older. As a result, anal cancer incidence surpassed cervical cancer among 65+-year-old women, while the gap is narrowing among women aged 55-64 years

  • Unfortunately,  disparities persist with Non-Hispanic Black and Hispanic women across age groups having greater cervical cancer incidence than non-Hispanic white women. 

Recent rise in cervical cancer incidence in Puerto Rico 

Overall, while cervical cancer incidence decreased in the contiguous United States (US) in the last few decades, in Puerto Rico (US territory), a marked and unfortunate rise was observed.  The absolute incidence in this territory is highest nationally. This study called for immediate attention to improve cervical cancer prevention in Puerto Rico.   

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